HOUR and Opioid OD Disposition!

PGY1 PGY2 PGY3 PGY4 Toxicology

When do you discharge a patient with opioid OD? Is it awake, alert ox3, Passed road test, articulate well? AEM published a prospective clinical prediction rule to assess when a patient is ready to be discharged! Hospital Observation Upon Reversal (HOUR) with naloxone will assess patients one hour after administration of prehospital naloxone. Six criteria were observed prior to discharge patient:

1. Ability to mobilize as usual
2. A normal oxygen saturation
3. A normal respiratory rate
4. A normal temperature
5. A normal heart rate
6. A normal GCS

This rule showed a sensitivity of 84.1%, a specificity of 62.1%, and a negative predictive value of 95.6%.

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